Chinese expert consensus on diagnosis and treatment of total anomalous pulmonary venous connection_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

CHEN Rui ¹ ,  XING Quansheng ¹ ,  ZHANG Hao ² ,  LI Shoujun ³ , Representatives of National Society for Congenital Heart Disease

1. Cardiac Center, Women and Children’s Hospital, Qingdao University, Qingdao, 266034, Shandong, P. R. China;
2. Department of Cardiothoracic Surgery, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200127, P. R. China;
3. Department of Pediatric Cardiac Surgery, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, P. R. China;

Corresponding author：

XING Quansheng, Email: xingqs0532@163.com; ZHANG Hao, Email: drzhanghao@126.com; LI Shoujun, Email: drlishoujunfw@163.com

Keywords：

Congenital heart disease; total anomalous pulmonary venous connection; expert consensus

DOI：

10.7507/1007-4848.202408043

Video：

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Abstract Full text Figures/Tables Video References Cited by

Total anomalous pulmonary venous connection (TAPVC) is a relatively rare but complex congenital heart disease characterized by the anomalous drainage of the pulmonary veins. Rather than connecting to the left atrium, the pulmonary veins drain either directly or indirectly into the systemic venous circulation or the right atrium via abnormal pathways. While there is broad consensus on the diagnostic criteria for TAPVC, significant debate persists regarding the optimal timing of surgical intervention, preferred surgical techniques, and postoperative management including re-intervention strategies. This article formulates a Chinese consensus based on evidence-based data from the literature and opinions from domestic experts, with the goal of further standardizing the surgical treatment of TAPVC in China.

Citation： CHEN Rui, XING Quansheng, ZHANG Hao, LI Shoujun, Representatives of National Society for Congenital Heart Disease. Chinese expert consensus on diagnosis and treatment of total anomalous pulmonary venous connection. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2024, 31(10): 1385-1391. doi: 10.7507/1007-4848.202408043 Copy

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1. Bharati S, Lev M. Congenital anomalies of the pulmonary veins. Cardiovasc Clin, 1973, 5(1): 23-41.
2. Karamlou T, Gurofsky R, Al Sukhni E, et al. Factors associated with mortality and reoperation in 377 children with total anomalous pulmonary venous connection. Circulation, 2007, 115(12): 1591-1598.
3. Seale AN, Uemura H, Webber SA, et al. Total anomalous pulmonary venous connection: Morphology and outcome from an international population-based study. Circulation, 2010, 122(25): 2718-2726.
4. Evans WN, Acherman RJ, Ciccolo ML, et al. An increased incidence of total anomalous pulmonary venous connection among Hispanics in southern Nevada. Congenit Heart Dis, 2015, 10(2): 137-141.
5. Jonas RA. Comprehensive Surgical Management of Congenital Heart Disease. London: Arnold. 2004, 402-413.
6. Keith JD, Rowe RD, Vlad P, et al. Complete anomalous pulmonary venous drainage. Am J Med, 1954, 16(1): 23-38.
7. Bonelli-Sica JM, de la Mora-Cervantes R, Diaz-Zamudio M, et al. Dual-source 256-MDCT for diagnosis of anomalous pulmonary venous drainage in pediatric population. AJR Am J Roentgenol, 2013, 200(2): W163-W169.
8. Burroughs JT, Kirklin JW. Complete surgical correction of total anomalous pulmonary venous connection; report of three cases. Proc Staff Meet Mayo Clin, 1956, 31(6): 182-188.
9. St Louis JD, Harvey BA, Menk JS, et al. Repair of "simple" total anomalous pulmonary venous connection: A review from the Pediatric Cardiac Care Consortium. Ann Thorac Surg, 2012, 94(1): 133-137.
10. 崔虎军, 陈欣欣, 马力, 等. 6月龄以内完全性肺静脉异位引流外科治疗经验. 中华外科杂志, 2016, 54(4): 276-280.Cui HJ, Chen XX, Ma L, et al. Surgical treatment experience of total anomalous pulmonary venous connection in infants under 6 months of age. Chin J Surg, 2016, 54(4): 276-280.
11. 郭张科, 杜军利, 李晓峰, 等. 255例完全性肺静脉异位引流手术治疗的单中心回顾性研究. 中国循环杂志, 2021, 36(1): 74-79.Guo ZK, Du JL, Li XF, et al. Surgical treatment of 255 cases of total anomalous pulmonary venous connection: A single-center retrospective study. Chin Circul J, 2021, 36(1): 74-79.
12. 欧艳秋, 聂志强, 庄建, 等. 单中心328例不同分型完全性肺静脉异位引流的临床特点和外科治疗早中期结果. 中华胸心血管外科杂志, 2017, 33(1): 10-15.Ou YQ, Nie ZQ, Zhuang J, et al. Clinical characteristics and early to mid-term outcomes of surgical treatment in 328 cases of different types of total anomalous pulmonary venous connection: A single-center study. Chin J Thorac Cardiovasc Surg, 2017, 33(1): 10-15.
13. 郑强, 林锐振, 马晓春, 等. 完全型肺静脉异位引流的外科治疗经验. 中国体外循环杂志, 2020, 18(3): 164-167.Zheng Q, Lin RZ, Ma XC, et al. Surgical treatment experience of total anomalous pulmonary venous connection. Chin J Extracorp Circ, 2020, 18(3): 164-167.
14. 肖飞, 陈国强, 黄雅婷, 等. 单中心完全性肺静脉异位引流外科手术患者产前诊断情况及早期效果分析: 来自22年间626例患者的分析. 岭南心血管病杂志, 2022, 28(2): 122-128.Xiao F, Chen GQ, Huang YT, et al. Prenatal diagnosis and early outcomes of patients with total anomalous pulmonary venous connection: Analysis of 626 cases over 22 years from a single center. South China J Cardiovasc Dis, 2022, 28(2): 122-128.
15. 王辉山, 李守军. 先天性心脏病外科治疗中国专家共识(十): 法洛四联症. 中国胸心血管外科临床杂志, 2020, 27(11): 1247-1254.Wang HS, Li SJ, on behalf of the National Cardiovascular Disease Expert Committee on Congenital Heart Disease. Chinese expert consensus on surgical treatment of congenital heart disease (Part 10): Tetralogy of Fallot. Chin J Clin Thorac Cardiovasc Surg, 2020, 27(11): 1247-1254.
16. 曾国炜. 混合型完全性肺静脉异位引流的解剖特征及治疗进展. 临床小儿外科杂志, 2021, 20(9): 881-885.Zeng GW. Anatomical characteristics and treatment progress of mixed total anomalous pulmonary venous connection. J Clin Pediatr Surg, 2021, 20(9): 881-885.
17. Files MD, Morray B. Total anomalous pulmonary venous connection: Preoperative anatomy, physiology, imaging, and interventional management of postoperative pulmonary venous obstruction. Semin Cardiothorac Vasc Anesth, 2017, 21(2): 123-131.
18. 裴秋艳, 何怡华, 李胜利. 胎儿心脏超声横切面正常与异常特征专家共识. 中国超声医学杂志, 2023, 39(6): 601-608.Pei QY, He YH, Li SL. Expert consensus on normal and abnormal features of fetal cardiac ultrasound cross-sectional views. Chin J Ultra Med, 2023, 39(6): 601-608.
19. Yang L, He X, Lu Y, et al. Integrated model for the prenatal diagnosis and postnatal surgical treatment of total anomalous pulmonary venous connection: A multidisciplinary collaborative experience and preliminary results. J Card Surg, 2019, 34(11): 1264-1272.
20. 吴淑燕, 江燕萍, 韩凤珍. 胎儿复杂性先天性心脏病产前与出生后诊断处理的价值及预后比较. 实用妇产科杂志, 2016, 32(1): 45-48.Wu SY, Jiang YP, Han FZ. Value and prognosis comparison of prenatal versus postnatal diagnosis and management of complex congenital heart disease. J Prac Obste Gynecol, 2016, 32(1): 45-48.
21. Brown VE, De Lange M, Dyar DA, et al. Echocardiographic spectrum of supracardiac total anomalous pulmonary venous connection. J Am Soc Echocardiogr, 1998, 11(3): 289-293.
22. 祝忠群, 张海波, 徐志伟, 等. 完全性肺静脉异位引流术后肺静脉狭窄的病理类型及手术治疗. 中华胸心血管外科杂志, 2012, 28(9): 522-525.Zhu ZQ, Zhang HB, Xu ZW, et al. Pathological types and surgical treatment of pulmonary vein stenosis after total anomalous pulmonary venous connection surgery. Chin J Thorac Cardiovasc Surg, 2012, 28(9): 522-525.
23. 武钦, 石磊, 倪伟, 等. 完全性肺静脉异位引流术后肺静脉梗阻的随访和再干预. 中华胸心血管外科杂志, 2021, 37(8): 462-466.Wu Q, Shi L, Ni W, et al. Follow-up and reintervention for pulmonary vein obstruction after total anomalous pulmonary venous connection surgery. Chin J Thorac Cardiovasc Surg, 2021, 37(8): 462-466.
24. Shen Q, Pa M, Hu X, et al. Role of plain radiography and CT angiography in the evaluation of obstructed total anomalous pulmonary venous connection. Pediatr Radiol, 2013, 43(7): 827-835.
25. 李晓华, 庄建, 陈寄梅, 等. 新生儿完全性肺静脉异位引流的矫治及预后相关危险因素分析. 中国胸心血管外科临床杂志, 2015, 22(12): 1138-1142.Li XH, Zhuang J, Chen JM, et al. Analysis of surgical correction and prognostic risk factors for total anomalous pulmonary venous connection in neonates. Chin J Clin Thorac Cardiovasc Surg, 2015, 22(12): 1138-1142.
26. Lacour-Gayet F. Surgery for pulmonary venous obstruction after repair of total anomalous pulmonary venous return. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu, 2006: 45-50.
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